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SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

ALPHA AGONISTS

Clonidine (Catapres) (Tenex)

BENEFITS OF THIS MEDICATION • These medications are commonly used to treat high blood pressure. Your doctor may have prescribed these medications to treat symptoms of attention deficit hyperactivity disorder (ADHD), a tic disorder or aggression.

PROPER USE OF THIS MEDICATION • Take this medication as prescribed by your doctor. Do not miss any doses, take it more frequently or increase the amount without your doctor’s approval. If you miss a dose, take it as soon as possible, but if it is close to your scheduled dose, skip it and go back to you regular dosing schedule, taking only the prescribed amount. Do not suddenly stop taking your medication – especially without your doctor’s approval. Abrupt discontinuation can result in nervousness and anxiety. • Store your medication away from excessive light, heat and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are an adolescent female of childbearing age, please read this carefully. You should use birth control since unexpected can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing mediation. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may need to exercise caution when operating machinery or driving a vehicle while you are getting adjusted to your medication. Do not drink alcohol while taking this medication. If you do drink alcohol, be sure to discuss this with your doctor. • Inform your physician of any cardiac or blood pressure problems.

POSSIBLE COMMON • Dry mouth • Drowsiness • • Weight gain • Constipation • Lightheaded feeling upon standing

If you have further questions, ask your doctor, nurse or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION NON-STIMULANTS

Atomoxetine HCL (Strattera)

BENEFITS OF THIS MEDICATION • Atomoxetine is used to treat attention deficit hyperactivity disorder (ADHD).

PROPER USE OF THIS MEDICATION • Take this medication as prescribed by your doctor. Do not miss any doses, take it more frequently or increase the amount without your doctor’s approval. If you miss a dose, take it as soon as possible, but if it is close to your scheduled dose, skip it and go back to your regular dosing schedule, taking only the prescribed amount. Do not suddenly stop taking your medication – especially without your doctor’s approval. • Store your medication away from excessive light, heat and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are an adolescent of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing mediation. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may need to exercise caution when operating machinery or driving a vehicle while you are getting adjusted to your medication. Do not drink alcohol while taking this medication. If you do drink alcohol, be sure to discuss this with your doctor. • Do not take atomoxetine with any of the monoamine oxidase inhibitor (MAOI) (e.g., Parnate, Nardil, Marplan). • Inform your physician if you are taking any of the SSRI antidepressants (e.g., Prozac, Paxil). Your dosage of atomoxetine may need to be adjusted. • Inform your physician of any cardiac or blood pressure problems. • Inform your physician if you have asthma. Atomoxetine should be used with caution in patients treated with albuterol (Ventolin) or similar agents. When these agents are combined with atomoxetine, blood pressure and heart rate can increase.

POSSIBLE COMMON SIDE EFFECTS • Dizziness • Reduced appetite • Upset stomach • Insomnia • Sedation • Mood swings If you have further questions, ask your doctor, nurse or pharmacist. Revised – 0710/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

BETA-BLOCKERS

Bisoprolol (Zebeta) Propanolol (Inderal) (Blocadren) Carvedilol (Coreg) (Corgard) (Lopressor, Toprol) (Tenormin) Labetolol (Trandate) Other:

COMMON USES AND BENEFITS OF THIS MEDICATION • These drugs belong to a group of medicines called beta-blockers. Beta-blockers are used to treat high blood pressure (), congestive (CHF), abnormal heart rhythms (arrhythmias), and chest pain (). Beta- blockers are sometimes used in heart attack patients to prevent future heart attacks and in migraine prophylaxis. In psychiatry, these medicines may be helpful in treating restlessness (akathisia), movement disorders caused by antipsychotic medications, or performance anxiety. Your doctor will discuss specifically with you how this medicine is being used, and the benefits of it.

PROPER USE OF THIS MEDICATION • Take this medicine regularly. Do not discontinue your medication abruptly, except on advice from your physician. • Learn how to check your pulse rate. Then, while you are taking this medication, check your pulse regularly. Notify your doctor if your pulse is below the rate advised by your doctor. • When you are under the care of another doctor or dentist, tell the doctor or dentist you are taking this medication. Check with your physician or pharmacist before taking other prescribed medications, over-the-counter drugs, vitamins or herbal supplements.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • This medicine may cause some people to become drowsy or lightheaded. Be sure you know how you react to this medicine before you drive, operate machinery, or do jobs that require alertness. • If you are diabetic (high blood sugar) and taking antidiabetic medications or insulin, beta-blockers may cover up signs of low blood sugar. Beta-blockers can also alter blood sugar levels. • If you have any of the following conditions, be sure to let your doctor know before taking this medication: asthma, chronic obstructive lung disease, allergy to foods or dyes, heart block, diabetes mellitus, or and breast feeding issues.

POSSIBLE COMMON SIDE EFFECTS • The more common side effects generally go away during treatment as your body becomes adjusted to the medication. However, check with your doctor if the following side effects continue or are bothersome:

• dizziness or lightheadedness • drowsiness • tiredness and weakness

• Less common side effects include:

• cold hands and feet • confusion, especially in the elderly • slow pulse (below 50 beats/minute) • depression If you have further questions with your particular medication, ask your physician or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

Anticonvulsants

Carbamazepine (Tegretol) Topiramate (Topamax) Gabapentin (Neurontin) (Depakene, Depakote, and Depakote ER) (Lamictal) (Trileptal) Other:

COMMON USES AND BENEFITS OF THIS MEDICATION • Bipolar disorder (manic depression): • Anger, aggression, impulsivity • Augmenting other medication (helping it work) • Other: epilepsy (seizure), headache

PROPER USE OF THE MEDICATION • Take the medication only as prescribed by your doctor. Do not miss any doses. Do not take it more frequently than prescribed nor increase the dose without your doctor’s permission. If you missed a dose, take it as soon as possible, but if it is close to your next scheduled dose, skip it and go back to your regular dosing schedule. • Do not abruptly stop your medication unless instructed to do so by your doctor. These medications may need to be tapered slowly before complete discontinuation. • Take medication with meals to reduce the likelihood of stomach upset. • Store medication away from heat and moisture, which may cause the medication to break down. • Do not make changes in your medication on your own. Check with your doctor if you have side effects, think about discontinuing or increasing it.

PRECAUTIONS WITH THESE MEDICATIONS • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • Any medication may cause drowsiness, lack of coordination—if this occurs, avoid activities in which danger is involved (e.g., driving, operating machinery). • Side effects other than those listed below may occur—if any are severe, talk with your doctor.

POSSIBLE COMMON SIDE EFFECTS • Depakene, Depakote, and Depakote ER—stomach upset, elevated tests, irregular menstrual periods, and rarely liver or pancreas failure. Take with meals. Notify your doctor if feeling ill or pain in the stomach. Initially, blood tests will be done to monitor the drug. • Lamictal—mild rash or rarely severe rash. Notify your doctor of any rash and go to the emergency room immediately if it is severe. • Neurontin—sedation, weight gain. • Tegretol—infection, feeling off balance, tremor, low blood count, elevated liver tests, irregular menstrual periods, and rarely liver failure. It may reduce the effectiveness of birth control pills. Take with meals. Notify your doctor if feeling ill or pain in the stomach. Initially, blood tests will be done to monitor the drug. • Topamax—numbness, sedation, kidney stones, and rarely confusion. It may reduce the effectiveness of birth control pills. • Trileptal—feeling off balance, tremor, tiredness, and rarely low sodium (causes irritability, confusion). It may reduce the effectiveness of birth control pills.

If you have further questions with your particular medication, ask you doctor or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

Lithium

Other names: Eskalith, Lithane, lithium carbonate, lithium citrate, Lithobid, Lithonate, Lithotabs

COMMON USES/BENEFITS OF THE MEDICATION

• Bipolar disorder (manic depression): • Augmenting other medication (helping it work)

PROPER USE OF THE MEDICATION

• Take medication with meals to reduce the likelihood of stomach upset • Store medication away from heat and moisture, which may cause the medication to break down • Do not make changes in your medication on your own. Check with your doctor if you have side effects, think about discontinuing or increasing it. • If you miss a dose etc., take as soon as possible, but if it is close to your next scheduled dose, skip it, go back to your regular dosing schedule.

PRECAUTIONS WITH YOUR MEDICATION

• If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medication on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • Available data indicates that patients taking lithium should NOT breast-feed their infants. • Blood monitoring is required from time to time to ensure adequate dosing and avoid toxicity. • Signs of toxicity are: confusion, slurred speech, nausea/vomiting, incoordination, increased tremor and blurred vision. Contact your physician immediately. • Avoid dehydration as it may increase the likelihood of toxicity. • Side effects other than those listed below may occur—if any are severe, talk with your doctor.

POSSIBLE COMMON SIDE EFFECTS

• Most commonly: drowsiness, , nausea, increased thirst and urination, slight tremor of hands and cognitive dulling. • Less frequently: bloating, weight gain, acne, rash, thyroid problems, kidney problems and irregular heartbeat.

POSSIBLE DRUG INTERACTIONS

• Certain blood pressure medications called (water pills) such as hydrochlorothiazide or furosemide (Lasix) and ACE Inhibitors such as benazepril (Lotensin) • Certain pain medications called nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil)

If you have further questions, ask you doctor, nurse or pharmacists. Revised 0710/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

Antidepressants

Mirtazapine (Remeron) (Serzone) (Desyrel) Other:

COMMON USE AND BENEFITS OF THIS MEDICATION • These medications are antidepressants approved for the treatment of depression. However, your doctor may use these medicines for other problems as well. For example, because trazodone produces drowsiness, your doctor may prescribe it at bedtime for insomnia. When trazodone is prescribed for sleep, it is only taken at bedtime. You may begin to feel the benefits of your medication after a week, but it takes two to four weeks for these antidepressants to achieve their full benefits.

PROPER USE OF THE MEDICATION • Take the medication only as prescribed by your doctor. Do not miss any doses. Do not take it more frequently than prescribed nor increase the dose without your doctor’s permission. If you missed a dose, take it as soon as possible, but if it is close to your next scheduled dose, skip it and go back to your regular dosing schedule. • Do not abruptly stop your medication unless instructed to do so by your doctor. These medications may need to be tapered slowly before complete discontinuation. • Store your in a safe place away from children, excessive heat, light and moisture.

PRECAUTIONS WITH THESE MEDICATIONS • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may experience some drowsiness or decreased alertness from your medication, especially when just starting on it. Make sure you know how you react to your medication before you drive a motor vehicle, operate machinery or perform tasks that require mental alertness. You should not drink alcoholic beverages when taking this medication. • If you are receiving prescription medications from another doctor, inform your doctor of the psychotropic medications you are taking. If you are taking an over-the-counter medication, ask your pharmacist if it is safe with this medication, and any precautions with the combination. • These medications may lower the blood pressure upon rising or standing from a lying or sitting position, causing dizziness and potential for fainting, especially for the elderly. During the first two weeks of starting therapy on one of these antidepressants, exercise caution by getting up slowly. This will allow your body to adjust slowly to the medication. • Do not combine any of the monamine oxidase inhibitor (MAOI) antidepressants (e.g., Parnate, Nardil, Marplan) with , trazodone or nefazodone. A severe reaction, resulting in high blood pressure, may ensue.

POSSIBLE SIDE EFFECTS • For males who are taking trazodone or nefazodone, there is a risk for developing priapism, which is a prolonged and painful penile erection. If this occurs, discontinue the medication, call your doctor, and go to the emergency room for treatment. • Nefazodone has been rarely linked to liver failure in some patients taking the drug. Symptoms of liver problem include malaise, jaundice (yellow skin tone) and general gastrointestinal discomfort. Your doctor may order laboratory tests periodically to check your liver function while you are taking nefazodone. • Mirtazapine may increase your appetite and result in weight gain. If you notice significant change in your appetite and weight, consult your doctor. Do not stop taking the medication without talking to your doctor.

If you have further questions with your particular medication, ask your doctor or pharmacist. Revised – 07/03/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

ANTIDEPRESSANTS—SEROTONIN REUPTAKE INHIBITOR GROUP

Celexa (Citalopram) Lexapro (Escitalopram) Luvox (Fluvoxamine) Paxil () Prozac (Fluoxetine) Zoloft (Sertraline) Other:

COMMON USES/BENEFITS OF THE MEDICATIONS • Depressive Disorders • Anxiety Disorders • Eating Disorders • Premenstrual Dysphoric Disorder

PROPER USE OF MEDICATION • Take this medication exactly as the physician prescribes. • Do not take more of it or take it longer than prescribed. • You may have to take this medication for 4 weeks or more to feel its full effects. • Do not make changes in your medication on your own. Check with your doctor if you have side effects, think about discontinuing or increasing or decreasing it.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • If you have any thoughts of suicide, contact your doctor right away. • This medicine may make you drowsy or dizzy. Do not drive or operate machinery unless you are fully alert. • This medicine may interact with many other medicines. Do not take any other medicine, including non-prescription products, unless your doctor approves. • Do not drink alcohol while you are taking this medicine. • Be sure to tell your doctor about all medicines you are taking including non-prescription medications, vitamins, natural remedies, and other over-the-counter products. • Keep all medicines out of reach of children. • Do not share this medication with other people.

POSSIBLE COMMON SIDE EFFECTS • Some side effects may go away as your body adjusts to the medicine. Tell your doctor if you have any side effects that continue or get worse.

• Headache, nausea, dry mouth, constipation, diarrhea, decreased appetite, drowsiness, dizziness, sweating, difficulty with sexual performance, nervousness, sleepiness, and anxiety.

If you have further questions, ask your doctor, nurse or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

Other Antidepressants and Anti-Anxiety Agents

Buproprion (Wellbutrin SR) Venlafaxine (Effexor XR) (BuSpar) Other:

BENEFITS OF THESE MEDICATIONS • These medications are used to treat depression and other psychiatric disorders. These medications are used to treat symptoms such as depressed moods, low energy, poor sleep and decreased appetite. These medications might be used by themselves or in combination with other medicines for depression or other psychiatric disorders as prescribed by your doctor.

PROPER USES OF THESE MEDICATIONS • Take these medicines exactly as directed by your doctor. Do not miss any doses, take it too frequently or increase the amount without your doctor’s approval. Taking too much of this medicine may increase the risk of side effects. If you miss a dose, take it as soon as possible, but if it is too close to your next scheduled dose, skip it and go back to your regular dosing schedule, taking the prescribed amount. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your health care provider. • Store your medication away from excessive sunlight, heat and moisture which may cause your medication to breakdown. • Do not crush or chew the sustained-release tablets or open up capsules, swallow them whole. Your doctor may also order laboratory tests during your treatment; be sure to get any tests done promptly.

PRECAUTIONS WITH YOUR MEDICATIONS • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • Each medication has side effects, some of which may be very serious and some which may go away as your body adjusts to the medicine. Tell your doctor if you have any side effects that continue or get worse. • Do not drink alcohol or take any illegal drugs while you are taking these medicines as they may increase side effects. Be sure that you tell all health care providers who treat you about all medicines you are taking, including nonprescription products, vitamins, and natural remedies. • Keeping your medication in a pillbox to help you remind yourself of your doses may help. Keep all medicines out of reach of children and do not share your medicines with other people. • Wellbutrin: do not take this medicine if you have seizures or epilepsy, unless approved by your doctor. Also do not take this medication if you are already taking Zyban or regular release Wellbutrin. • Effexor: do not take this medicine with an MAO inhibitor antidepressant such as phenelzine (Nardil), tranylcypromine (Parnate), or isocarboxazid (Marplan) 14 days of each other. Also alert your doctor if you have high blood pressure (hypertension) and plan to or are already on this medicine. • BuSpar: do not take this medicine with an MAO inhibitor antidepressant such as phenelzine (Nardil), tranylcypromine (Parnate), or isocarboxazid (Marplan) 14 days of each other. Also, alert your doctor if you plan to or are already on any other antidepressant medications.

If you have further questions, ask your doctor, nurse or pharmacists. Revised 0710/03 SACRAMENTO COUNTY MENTAL HEALTH MEDICATION INORMATION Benzodiazepines

Lorazepam (Ativan) Flurazepam (Dalmane) Chlordiazepoxide (Librium) Oxazepam (Serax) Clonazepam (Klonopin) Temazepam (Restoril) Diazepam (Valium) Other:

COMMON USE AND BENEFITS OF THIS MEDICATION • These medications belong to the group of medications called benzodiazepines or sedatives/hypnotics. They are used for a variety of illnesses: anxiety for the reduction of nervousness, tension, and/or worry; insomnia; tension and/or irritability with other illnesses; panic attacks; alcohol withdrawal; seizures; and movement disorders.

PROPER USE OF THIS MEDICATION • Take the medication only as prescribed by your doctor. Do not miss any doses. Do not take it more frequently than prescribed nor increase the dose without your doctor’s permission. If you missed a dose, take it as soon as possible, but if it is close to your next scheduled dose, skip it and go back to your regular dosing schedule. • Do not abruptly stop your medication unless instructed to do so by your doctor. These medications may need to be tapered slowly before complete discontinuation. • For insomnia, you may need to take the medication 30 to 60 minutes before bedtime. • Store your medication away from excessive light, heat, and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • These medications can cause drowsiness, dizziness, impaired coordination, grogginess and/or confusion—avoid tasks that require alertness (i.e., driving or operating machinery) when starting the medication and changing doses. Alcohol, pain medications and other sedative drugs will intensify the effect of these drugs. In addition, elderly persons are more sensitive to these effects.

POSSIBLE COMMON SIDE EFFECTS • Some of the other more commonly reported sided effects with the medication you are taking include: • memory loss • blurred vision • stomach upset • shortness of breath • depression • Long-term use of these medications can lead to tolerance and withdrawal.

If you have further questions, ask your doctor, nurse or pharmacist. Revised – 07/01/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

ATYPICAL ANTIPSYCHOTICS

Aripiprazole (Abilify) (Risperdal) (Zyprexa) (Geodon) (Seroquel) Other:

COMMON USES/BENEFITS OF THIS MEDICATION • These medications belong to the group of antipsychotic agents commonly called the atypical antipsychotics. These medications treat the symptoms of schizophrenia, as well as other mental illnesses, including hearing voices, feeling paranoia and unusually suspicious and abnormal thoughts and behavior. • All antipsychotic medications can produce side effects, such as muscle stiffness, tremors or uncontrollable restlessness. These side effects are commonly called extrapyramidal symptoms (EPS). At the recommended doses, the atypical antipsychotics generally produce less frequent or severe extrapyramidal side effects than other (typical) antipsychotic medications.

PROPER USE OF THIS MEDICATION • Take this medication as prescribed by your doctor. Do not miss any doses, take it more frequently or increase the amount without your doctor’s approval. If you missed a dose, take it as soon a possible, but if it is close to your scheduled dose, skip it and go back your regular dosing schedule, taking only the prescribed amount. Do no suddenly stop taking your medication without your doctor’s approval. • Store your medication away from excessive light, heat and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since expected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may experience drowsiness from your medication at the start of therapy and at higher doses. You need to exercise caution when operating machinery or driving a vehicle while you are getting adjusted to your medication. Do no drink alcohol while taking this medication. If you do drink alcohol, be sure to discuss this with your doctor. • Sudden discontinuation of your medication may result in return of your symptoms. It is very important that you do not stop your medication without your doctor’s approval. • Geodon is associated with a small risk of cardiac rhythm disturbance. Geodon may change the electrical conduction of your heart and alter the conduction rate. Usually this effect is not harmful, but if you have a history of heart problems your doctor will decide carefully if Geodon is safe for you. If you are taking other medications, including over-the counter, including over-the counter medications and herbal supplements, tell your doctor. Some of these medications may not be safe in combination with Geodon. • You may experience lightheadedness or dizziness when you rise too rapidly from a lying or sitting position. To avoid falling or fainting, rise slowly when you stand up; from a lying position, sit up first then stand up. If this side effect persist, discuss this with your doctor.

If you have further questions, ask you doctor, nurse or pharmacist. Revised – 07/10/03

Page 1 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

ATYPICAL ANTIPSYCHOTICS

POSSIBLE COMMON SIDE EFFECTS • Constipation • Sedation • Blurred vision • Dry mouth • Difficulty with urination • Drowsiness is the most common complaint with these medications, especially with Zyprexa. You should develop tolerance to this side effect after the first week of starting medication. • You may experience some muscle stiffness and uncoordinated movements, especially if you are taking Risperdal at higher doses. If this side effect persists, discuss it with your doctor. • Weight gain, especially with Zyprexa.

POSSIBLE ADVERSE REACTIONS WITH MEDICATIONS • Some of these medications may impair you body’s ability to handle sugar (glucose), which is similar to diabetes. If you have a history, or a family history, of diabetes, discuss this with your doctor, so that you can be closely monitored for signs and symptoms of diabetes. • Geodon has been associated with disturbances in heart rhythm. • All antipsychotic medications are associated with a small risk of causing seizures. If you have a history of seizures, your doctor will discuss the risk with you. • Long-term use of antipsychotic medications is associated with the possible development of Tardive Dyskinesia, a condition consisting of involuntary movements and spasms of the face, tongue, and fingers, as well as the extremities of the body. These abnormal movements may become permanent. Tardive Dyskinesia is more common with use of the older medications. With the new atypical antipsychotics, the associated risk is very low, which is one of the distinct advantages of these medications.

If you have further questions, ask you doctor, nurse or pharmacist. Revised – 07/10/03

Page 2 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

CLOZAPINE (CLOZARIL)

COMMON USES/BENEFITS OF THIS MEDICATION • This medication belongs to the newer group of antipsychotic agents commonly called the atypical antipsychotics. ’s brand name is Clozaril and it also exists in generic form. It is used to treat the symptoms of schizophrenia and other mental illnesses. These symptoms include hearing voices, feeling suspicious, and having abnormal thoughts and behaviors.

PROPER USE OF THIS MEDICATION • Take this medication exactly as directed. Do not take it more or increase the dose without approval from your doctor. Do not suddenly stop taking this medication without notifying your doctor. Your dose may need to be gradually decreased. During the first week of treatment your dose may be adjusted until the best dose for you is identified. • Blood tests need to be run routinely when taking this medication.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medication on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • Tell your doctor if you have a history of glaucoma, seizure disorders, heart or blood vessel disease, kidney, or liver disease, enlarged prostate or blood disorder. Do not allow anybody else to take this medication. Limit alcohol intake since this can result in excessive drowsiness.

POSSIBLE COMMON SIDE EFFECTS • This medication may cause drowsiness or dizziness. Use caution performing tasks that require alertness. Other common side effects include stomach upset, constipation, dry mouth, drooling, headache and tremor. These should disappear as your body adjusts to the medication. To prevent excessive dizziness, rise slowly from a flat or seated position. Avoid sudden changes in posture and be careful on stairs. Suck on hard candy or ice chips to help relieve dry mouth. • Inform your doctor if they become bothersome. Notify your doctor if you have diabetes or a history of seizure disorder. Also notify your doctor if you develop chest pain, rapid heart rate, difficulty breathing, aching muscles and joints, or rash. Theses may be signs that your dosage needs to be adjusted. If you develop sore throat, fever, weakness, flu-like symptoms, or experience a seizure while taking this medication, notify your doctor immediately. Weight gain is associated to use of this medication.

If you have further questions with your particular medication, ask your physician or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

Typical Antipsychotics

Chlorpromazine (Thorazine) (Serentil) (Trilafon) Perphenazine (Trilafon) (Prolixin) Pimozide (Orap) Fluphenazine Decanoate (Prolixin Decanoate) Thiothixene (Navane) (Haldol) (Stelazine) (Haldol Decanoate) Other:

COMMON USE AND BENEFITS OF THIS MEDICATION • These medications can help symptoms such as hearing disturbing voices, paranoia, anxiety, or other abnormal thoughts or behavior. They are typical antipsychotic medications which have helped patients for many years. In recent years newer antipsychotic medications have been developed, called atypical antipsychotics, which are preferred for many patients. But some people are better treated with these typical antipsychotic medications.

PROPER USE OF THESE MEDICATIONS • Take this medication as prescribed by your doctor. Do not miss any doses. Do not take it more frequently or increase the amount without your doctor’s approval. If you miss a dose, take it as soon as possible, unless it is close to your next scheduled dose; skip it and go back to your regular dosing schedule in that case. Do not suddenly stop taking your medications, especially without your doctor’s approval. • Store your antipsychotic in a safe place away from children, excessive heat, light and moisture.

PRECAUTIONS WITH THESE MEDICATIONS • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medication on the fetus. If you plan to become pregnant or are pregnant tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may experience some drowsiness or decreased alertness from your medication, especially when just starting on it. Make sure you know how you react to your medication before you drive a motor vehicle, operate machinery or perform tasks that require mental alertness. You should not drink alcoholic beverages when taking this medication. • If you are receiving prescription medications from another doctor, inform your doctor of the medications you are taking. If you are taking an over-the-counter medication, ask your pharmacist if it is safe to take with this medication.

POSSIBLE COMMON SIDE EFFECTS • Some of the more commonly reported sided effects with the medication you are taking include: • muscle spasms, especially of the face, neck and back; restlessness; or shaking of your hands—your doctor may prescribe another medication like Cogentin, Artane or Benadryl to prevent or treat this. • disturbance in your walk, with shuffling of your feet—same. • blurred vision—same. • difficulty in urination—other medication may help. • constipation—liquids, over-the-counter preparations, and other medications may help. • drowsiness—usually temporary. • dizziness or lightheadedness when getting up too fast—usually temporary. • sensitivity to sunlight—use an appropriate sunscreen and avoid too much sun. • dry mouth—suck on sugarless candy or ice chips. • Tardive dyskinesia: the use of antipsychotic medications is sometimes associated with a condition consisting of abnormal movements of the face, tongue, lips, fingers, or other parts of the body. This condition is called tardive dyskinesia. It appears to be a less common problem with some of the newer atypical antipsychotic medications. If you develop tardive dyskinesia it can be reversible if it is recognized early and the medication can be stopped. This condition also occurs in people with schizophrenia who have never been treated with antipsychotic medications. • Other

If you have further questions, ask your doctor, nurse or pharmacist. Revised – 07/10/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

ANTIDYSKINETICS

Amantadine (Symmetrel) Procyclidine (Kemadrin) Diphenhydramine (Benadryl) Biperiden (Akineton) Benztropine (Cogentin) Trihexyphenidyl (Artane) Other:

COMMON USES/BENEFITS OF THIS MEDICATION • These medications have been used to treat Parkinson’s disease. In your case, they are being used to prevent side effects, such as muscle stiffness and spasms, which may be caused by antipsychotic medication.

PROPER USE OF THIS MEDICATION • Take this medication as prescribed by your doctor. Do not miss any doses, do not take it more frequently or do not increase the amount without your doctor’s approval. If you missed a dose, take it as soon as possible, but if it is close to your scheduled dose, skip it and go back to your regular dosing schedule, taking only the prescribed amount. • Store your medication away from excessive light, heat and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medication on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing medication. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may experience drowsiness from your medication at the start of therapy and at higher doses. You need to exercise caution when operating machinery or driving a vehicle while you are getting adjusted to your medication. Do not drink alcohol while taking this medication. If you do drink alcohol, be sure to discuss this with your doctor. • This medication may cause constipation. Using a stool softener, (e.g. Colace) and increasing your fluid intake, under the advice of your doctor, may reduce or eliminate this problem. • Your mouth and throat may feel more dry while you are taking this medicine, especially when you start the medication. This will subside. Chewing a sugarless gum or sucking on ice chips may help relieve dryness of the mouth. If you find the side effect of this medicine too bothersome, inform your doctor. • Keep this medicine out of reach of children. Overdoses can be extremely dangerous in young children. • Inform your doctor immediately before taking this medicine if you have the following conditions: • pregnancy • enlarged prostate • a heart condition • or glaucoma (increased pressure of eyes).

POSSIBLE COMMON SIDE EFFECTS • There are some side effects of this medication that are common and often go away during treatment after a few days. However, if they persist or become too bothersome, inform your doctor. Common side effects include: • drowsiness • dryness of mouth and throat • constipation • upset stomach and blurred vision • If you have any of the following side effects, inform your doctor immediately: • mental confusion • difficulty in urination • dizziness • rapid pulse of eye pain If you have further questions with your particular medication, ask your physician or pharmacist. Revised – 0710/03 SACRAMENTO COUNTY MENTAL HEALTH

MEDICATION INFORMATION

STIMULANTS

Amphetamines (Dexedrine, Adderall, others) Methylphenidate (Ritalin, Concerta) Pemoline (Cylert), Use special consent form from current PDR.

BENEFITS OF THIS MEDICATION • Stimulant medications are used to treat narcolepsy, attention deficit hyperactivity disorder, obesity, and occasionally depression. If used in treating depression, the length of treatment is generally brief.

PROPER USE OF THIS MEDICATION • Take this medication as prescribed by your doctor. Do not miss any doses, take it more frequently or increase the amount without your doctor’s approval. If you miss a dose, take it as soon as possible, but if it is close to your scheduled dose, skip it and go back to you regular dosing schedule, taking only the prescribed amount. Do not suddenly stop taking your medication – especially without your doctor’s approval. • Store your medication away from excessive light, heat and moisture that may cause your medication to breakdown.

PRECAUTIONS WITH YOUR MEDICATION • If you are a woman of childbearing age, please read this carefully. You should use birth control since unexpected pregnancies can occur and we do not know all of the effects of medications on the fetus. If you plan to become pregnant or are pregnant, tell your doctor immediately. Your doctor will help you weigh the benefits and risks of continuing mediation. If you plan to breast feed, tell your doctor since some medications may enter breast milk. • You may experience restlessness from your medication at the start of therapy and at higher doses. You need to exercise caution when operating machinery or driving a vehicle while you are getting adjusted to your medication. Do not drink alcohol while taking this medication. If you do drink alcohol, be sure to discuss this with your doctor.

POSSIBLE COMMON SIDE EFFECTS • anxiety • insomnia • reduced appetite • dry mouth • suspiciousness • weight loss • irritability

If you have further questions, ask your doctor, nurse or pharmacist. Revised – 07/10/03